Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 19;79(9):853-860.
doi: 10.1136/thorax-2023-221275.

Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure

Inge Brosbøl Iversen  1 , Jesper Medom Vestergaard  2 , Ioannis Basinas  3 , Johan Ohlander  4 , Susan Peters  4 , Elisabeth Bendstrup  5 , Jens Peter Ellekilde Bonde  6 , Vivi Schlünssen  7 , Finn Rasmussen  8 , Zara Ann Stokholm  2 , Michael Brun Andersen  9   10 , Hans Kromhout  4 , Henrik Albert Kolstad  2   11
Affiliations

Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure

Inge Brosbøl Iversen et al. Thorax. .

Abstract

Background: Organic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and hypersensitivity pneumonitis and other ILDs in a cohort study.

Methods: The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994-2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model.

Results: For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensitivity pneumonitis and 1.04 (95% CI 1.02 to 1.06) for other ILDs. We found increasing risk with increasing cumulative endotoxin exposure for hypersensitivity pneumonitis and other ILDs with IRRs per 5000 endotoxin units/m3-years of 1.55 (95% CI 1.38 to 1.73) and 1.09 (95% CI 1.00 to 1.19), respectively. For both exposures, risk also increased with increasing duration of exposure and recent exposure. No increased risks were observed for wood dust exposure.

Conclusion: Exposure-response relations were observed between organic dust and endotoxin exposure and hypersensitivity pneumonitis and other ILDs, with lower risk estimates for the latter. The findings indicate that organic dust should be considered a possible cause of any ILD.

Trial registration number: j.no.: 1-16-02-196-17.

Keywords: hypersensitivity pneumonitis; interstitial fibrosis; occupational lung disease.

PubMed Disclaimer

Conflict of interest statement

Competing interests: EB has received payment for lectures from Daiichi-Sankyo, Boehringer Ingelheim, AstraZeneca and Hoffmann-la-Roche and support for attending meetings from Boehringer Ingelheim. VS has been Chair of the Danish Quality Committee for Occupational Exposure Limits of the Danish Working Environment Authority from 2016 to 30 June 2022. MBA has received grants from the Danish Center for Lung Cancer Research, Innovation Fund Denmark and AI Signature funds from the Danish government and has received payment for lectures from Boehringer Ingelheim. HK has received a grant from Industrial Minerals Association Europe for managing the IMA-DUST Monitoring Programme. All other authors have nothing to disclose.

Figures

Figure 1
Figure 1
Establishment of the study population. ISCO-88, 1988 International Standard Classification of Occupations.
Figure 2
Figure 2
Restricted cubic spline fits of incidence rate ratios of hypersensitivity pneumonitis, other ILDs and all ILDs by cumulative organic dust exposure, cumulative endotoxin exposure and cumulative wood dust exposure. Dotted lines mark 95% CIs. EU, endotoxin units; ILDs, interstitial lung disease.
See this image and copyright information in PMC

References

    1. Douwes J, Thorne P, Pearce N, et al. . Bioaerosol health effects and exposure assessment: progress and prospects. Ann Occup Hyg 2003;47:187–200. 10.1093/annhyg/meg032 - DOI - PubMed
    1. Basinas I, Sigsgaard T, Kromhout H, et al. . A comprehensive review of levels and determinants of personal exposure to dust and Endotoxin in livestock farming. J Expo Sci Environ Epidemiol 2015;25:123–37. 10.1038/jes.2013.83 - DOI - PubMed
    1. Jacobsen G, Schaumburg I, Sigsgaard T, et al. . Non-malignant respiratory diseases and occupational exposure to wood dust. part II. Ann Agric Environ Med 2010;17:29–44. - PubMed
    1. Cramer C, Schlünssen V, Bendstrup E, et al. . Risk of hypersensitivity Pneumonitis and interstitial lung diseases among pigeon BREEDERS. Eur Respir J 2016;48:818–25. 10.1183/13993003.00376-2016 - DOI - PubMed
    1. Sigsgaard T, Bonefeld-Jørgensen EC, Hoffmann HJ, et al. . Microbial cell wall agents as an occupational hazard. Toxicol Appl Pharmacol 2005;207:310–9. 10.1016/j.taap.2004.12.031 - DOI - PubMed

Publication types